No abstract

This article explores how individuals might make sense of chronic illness. The spiritual aspect of self is described both as being central to finding meaning in suffering with a chronic illness and also the source of hope in meeting the challenges faced. Culture as the template for interpreting the significance of chronic ill health at a personal, familial and societal level is also considered. A conceptual model for understanding life transitions is modified to incorporate the spiritual and cultural perspectives of making sense of chronic illness in relation to coping skills. In understanding how patients make sense of their circumstances nurses are more likely to be able to offer appropriate support to effect coping.

This article considers the care of a patient admitted into a hospice environment for pain management and respite care. The concept of 'total' pain is discussed together with the need for a multidimensional assessment of pain to enable effective management to be accomplished. A multiprofessional approach to care along with inclusion of both the patient and her husband in decision making achieved the best possible quality of life for them both. A palliative care approach requires healthcare professionals to focus on the achievement of quality of life for all patients whose disease is not responsive to curative treatment. This is achieved by providing relief from pain and other distressing symptoms, including psychological, spiritual and social aspects of care, together with the acknowledgement of patient and relative autonomy. Hence, the study also exemplifies contemporary palliative care in action.

No abstract

This article considers the value of bereavement theory to nurses. The contexts in which nurses care for the bereaved are identified and the terms "bereavement", "grief"and "mourning" are defined. A selection of psychological and sociological bereavement theory and models are considered in relation to their value in nursing practice. The increasing richness of bereavement theory strengthens potential understanding of the process of grief. Critical and creative use of this theory can offer valuable guidance to nurses caring for the bereaved and can help promote confidence, thus enabling them to provide appropriate support.